This invention relates generally to cutting devices and more particularly to surgical instruments for use in applications requiring limited access and/or careful instrument manipulation, such as arthroscopic surgery.
With the increase of active participations of Americans in fitness and exercise related activities has come a concomitant increase in sports/exercise related injuries, particularly to the joints. Such injuries frequently require surgery for correction. One common type of procedure now in use for intra-articular (joint) surgery is arthroscopic surgery. Such surgery involves viewing and surgical instruments probes inserted into the joint region through a small opening and without laying the joint open. Some of the more common procedures done arthroscopically are accomplished on the knee and include removal of loose bodies, shaving of the patella, resection of cartilage, resection of the meniscus, removal of synovial tissue, realignment of the knee cap, and abrasion of exposed areas of bone to promote regrowth of cartilage. Other areas of the body, such as the ankle, elbow, hip, and wrist, are also being arthroscopically repaired.
Various manual (hand) or powered instruments are commercially available for effecting arthroscopic surgery. Examples of hand instruments are forceps, grasps, knives, punches, etc. Powered instruments frequently make use of rotating blades for effecting a shaving-like procedure on joint tissue. For example, in U.S. Pat. No. 4,203,444 there is shown a shaver-type powered arthroscopic surgical instrument.
Unfortunately, current methods for resecting cartilage using hand or manual instruments during arthroscopic surgery have limitations. In this regard during arthroscopic surgery the hand-to-eye motor coordination of the surgeon is frequently impaired due to the fact that the surgeon carries out the procedure by watching an image on a monitor and not looking directly at the situs of the surgery. In addition, the surgeon usually holds the arthroscope in one hand, a knife or punch in the other, and uses them concomitantly. Due to the toughness or cut-resistence of the tissues cutting requires considerable pressure, with some constraints on flexibility. Moreover, reshaping of tissues is difficult since the use of a knife or a punch does not provide a smooth surface. The use of powered instruments has not obviated all of the problems of the prior art. For example the shaver-type devices while well suited to shave cartilage have proven too slow for resection.
Thus, the need exists for a surgical instrument which facilitates resection and molding of cartilage surface quickly, with little need for hand pressure, thus maximizing flexibility of movement in all directions, and while not obscuring vision of the surgeon.